本研究的目的是确定与儿童癌症幸存者 (CCS) 慢性疲劳 (CF) 相关的因素。参与者来自荷兰儿童癌症幸存者研究 (DCCSS) LATER 队列，这是一个全国性 CCS 队列（≥5 年后）诊断）和兄弟姐妹作为对照。疲劳严重程度通过个人力量检查表（“CIS-疲劳”）的“疲劳严重程度子量表”进行评估。 CF 被定义为“CIS 疲劳”评分≥35 且疲劳症状持续≥6 个月。评估了二十四个参数，分为假设的疲劳触发因素、维持因素和调节因素。我们进行了多变量逻辑回归分析，以调查这些因素与 CF 的关联。共有 1927 名 CCS 参与了这项研究（受邀队列的 40.7%），其中 23.6% 报告了 CF（相比之下，兄弟姐妹对照中的这一比例为 15.6%，P < 0.001）。以下因素与 CF 相关： 肥胖 [与健康体重相比，比值比 (OR) 1.93； 95% 置信区间 (CI) 1.30-2.87]、中度身体活动不足（与身体活动相比，OR 2.36；95% CI 1.67-3.34）、睡眠质量差（是与否，OR 2.03；95% CI 1.54-2.68），（亚）临床焦虑（是与否，OR 1.55；95% CI 1.10-2.19）、（亚）临床抑郁（是与否，OR 2.07；95% CI 1.20-3.59）、疼痛（持续，OR 1.49；95% CI 1.33-1.66)、自尊（连续，OR 0.95；95% CI 0.92-0.98）、无助（连续，OR 1.13；95% CI 1.08-1.19）、社会功能（连续，OR 0.98；95% CI 0.97 -0.99）和女性（相对于男性，OR 1.79；95% CI 1.36-2.37）。CF 是 CCS 的常见症状，与多种假设的维持因素相关，其中生活方式和社会心理因素最为突出。这些是可修改的因素，因此可能有利于预防或减少 CCS 中的 CF。版权所有 © 2023 作者。由爱思唯尔有限公司出版。保留所有权利。

The purpose of this study was to determine factors associated with chronic fatigue (CF) in childhood cancer survivors (CCS).Participants were included from the Dutch Childhood Cancer Survivor Study (DCCSS) LATER cohort, a nationwide cohort of CCS (≥5 years after diagnosis) and siblings as controls. Fatigue severity was assessed with the 'fatigue severity subscale' of the Checklist Individual Strength ('CIS-fatigue'). CF was defined as scoring ≥35 on the 'CIS-fatigue' and having fatigue symptoms for ≥6 months. Twenty-four parameters were assessed, categorized into assumed fatigue triggering, maintaining and moderating factors. Multivariable logistic regression analyses were carried out to investigate the association of these factors with CF.A total of 1927 CCS participated in the study (40.7% of invited cohort), of whom 23.6% reported CF (compared with 15.6% in sibling controls, P < 0.001). The following factors were associated with CF: obesity [versus healthy weight, odds ratio (OR) 1.93; 95% confidence interval (CI) 1.30-2.87], moderate physical inactivity (versus physical active, OR 2.36; 95% CI 1.67-3.34), poor sleep (yes versus no, OR 2.03; 95% CI 1.54-2.68), (sub)clinical anxiety (yes versus no, OR 1.55; 95% CI 1.10-2.19), (sub)clinical depression (yes versus no, OR 2.07; 95% CI 1.20-3.59), pain (continuous, OR 1.49; 95% CI 1.33-1.66), self-esteem (continuous, OR 0.95; 95% CI 0.92-0.98), helplessness (continuous, OR 1.13; 95% CI 1.08-1.19), social functioning (continuous, OR 0.98; 95% CI 0.97-0.99) and female sex (versus male sex, OR 1.79; 95% CI 1.36-2.37).CF is a prevalent symptom in CCS that is associated with several assumed maintaining factors, with lifestyle and psychosocial factors being the most prominent. These are modifiable factors and may therefore be beneficial to prevent or reduce CF in CCS.Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.